Does your ideal day in the lab include spending hours reviewing routine results before releasing them? The need for critical thinking is minimized and there's no interaction with pathologists and physicians.
Or, would you prefer exercising your skills by analyzing flagged results and monitoring quality functions? As more clinical labs adopt autoverification, laboratorians are finding a new satisfaction in their careers as automating the routine work frees them to focus on the most interesting aspects of diagnostics.
Autoverification is the automatic release of test results received from a lab instrument without laboratorian review based on pre-determined rules. As a number of competing forces (increased test volumes, shortage of skilled diagnosticians, reform-related issues) place growing pressure on labs, autoverification is one strategy to improve workflow and efficiency, and free up valuable staff time.
But Won't That Steal Our Jobs?
It may seem counter-intuitive that automating a job traditionally performed by a human creates the need for more skilled workers rather than eliminating jobs. Pamela Riddle, MT(ASCP)HHS, a Lean- and Green Belt Six Sigma-certified laboratorian, explains the old fear that tools like autoverification eliminate jobs for lab professionals is unfounded. While it's taking care of the routine results, "we have education, pre- and post-analytic issues to track, point-of-care training, monitoring quality functions and training new talent" to fill our time, she points out.
Kathy Sartorius, MLS(ASCP)CM, generalist at Sutter Health in Sacramento, adds, "For me, it has meant the opportunity to focus on the problems." This means getting to think critically and analyze non-routine results. She says she can concentrate on "the samples that may need to be diluted, or the lipemic sample that needs to be ultra-centrifuged, or the critical calls. Autoverification has meant that the routine samples that have normal values just pass right through the system without any intervention. I work in a hospital lab, so I can focus my time on the samples that don't necessarily conform to those standards."
Chemistry is one of the most popular and common areas of the lab to begin autoverification. Debra Krinke, medical technologist, Aurora Clinical Laboratories, says her lab currently only autoverifies chemistry. And even in chemistry, only about half of the tests are autoverified, namely, "the ones that do not have criticals, failed delta, error codes, below and above assay range," she explains.
Riddle adds that the implementation process is a group effort that takes time and careful planning to get up and running. This makes it easier to accept and embrace the changes. "It's a work in progress," she says, and it's certainly not like all of a sudden one day your manager will make a decision to autoverify and immediately all of your results will be automatically released.
As always, the ultimate benefit of autoverification comes from improved patient care that results from more consistent and reliable results and faster turnaround times. "The volume of work we can release is amazing," Riddle says, "and the emergency department [ED] is happier. So many times the techs are diluting, calibrating, planting, taking phone calls. That ED result, if within limits, is autoreleased as soon as it is complete."
Change can be intimidating, especially for laboratorians who may be used to a process they may have been using for decades. Those who spoke with ADVANCE admit that despite any apprehensions they may have experienced before adopting autoverification, they now find that it has enhanced not only workflow, but job satisfaction as well. If your manager is considering autoverification, be involved in the process from the beginning to ease apprehension and reap the greatest benefits.
Kelly Graham Bocich is associate editor of ADVANCE.